Chest congestion

Chest congestion is the uncomfortable sensation of the chest feeling heavy, full or blocked, usually because of a build-up of mucus in the airways, often with a cough that brings some up. It most commonly comes from a respiratory infection — a cold, bronchitis, flu or a chest infection — where inflammation makes the airways produce excess mucus. It is also a feature of longer-term airway diseases such as asthma and COPD, which can flare up with more mucus and tightness, and of allergies or post-nasal drip, where mucus from the nose and sinuses drains into the throat and chest. Less often, a heavy or congested feeling in the chest reflects fluid in the lungs from heart failure, particularly when it comes with breathlessness — especially lying flat — and ankle swelling. The word 'congestion' is also sometimes used loosely for a tight or heavy chest without much mucus, which overlaps with chest tightness. Most chest congestion from a viral infection settles within a week or two, but congestion that is persistent, comes with a high fever, breathlessness or chest pain, or brings up blood or discoloured phlegm, needs to be looked into.

• Respiratory infection — a cold, bronchitis, flu or a chest infection (pneumonia).
• Asthma — congestion and tightness, often with wheeze and cough.
• COPD — especially during a flare-up.
• Allergies or post-nasal drip — mucus draining from the nose and sinuses.
• Heart failure — fluid in the lungs, typically with breathlessness and ankle swelling.
• Smoking — chronic airway irritation and mucus.

Chest congestion is assessed mainly by the story and a chest examination, with oxygen levels and, when needed, a chest X-ray and breathing tests. Blood tests support this depending on the picture: a full blood count and CRP for infection or inflammation, and, if heart failure is a possibility (congestion with breathlessness and swelling), NT-proBNP as a heart-strain marker. Mediora.AI can surface an infection or a heart-strain pattern from your results, but chest congestion — particularly if it is persistent, or comes with breathlessness, chest pain or a high fever — is assessed in person, and any severe breathlessness or chest pain needs urgent care.